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Otol Neurotol. 2011 Jun;32(4):571-80. doi: 10.1097/MAO.0b013e318210b8fa.

Evidence of central and peripheral vestibular pathology in blast-related traumatic brain injury.

Author information

  • 1Department of Physical Therapy and Rehabilitation Science, University of Maryland, Baltimore, Maryland, USA. Matthew.scherer@us.army.mil

Abstract

OBJECTIVE:

To prospectively assay the vestibular and oculomotor systems of blast-exposed service members with traumatic brain injury (TBI).

STUDY DESIGN:

Prospective, nonblinded, nonrandomized descriptive study.

SETTING:

Tertiary care facility (Department of Defense Medical Center).

PATIENTS:

Twenty-four service members recovering from blast-related TBI sustained in Iraq or Afghanistan.

INTERVENTIONS:

Focused history and physical, videonystagmography (VNG), rotational chair, cervical vestibular-evoked myogenic potentials, computerized dynamic posturography, and self-report measures.

RESULTS:

Vestibular testing confirms a greater incidence of vestibular and oculomotor dysfunction in symptomatic (vestibular-like dizziness) personnel with blast-related TBI relative to asymptomatic group members. VNG in the symptomatic group revealed abnormal nystagmus or oculomotor findings in 6 of 12 subjects tested. Similarly, rotational chair testing in this group revealed evidence of both peripheral (4/12) and central (2/12) vestibular pathology. By contrast, the asymptomatic group revealed less vestibular impairment with 1 of 10 rotational chair abnormalities. The asymptomatic group was further characterized by fewer aberrant nystagmus findings (4/12 abnormal VNGs). Computerized dynamic posturography testing revealed no significant differences between groups. Self-report measures demonstrated differences between groups.

CONCLUSION:

Vestibular function testing confirms a greater incidence of peripheral vestibular hypofunction in dizzy service members with blast-related TBI relative to those who are asymptomatic. Additionally, oculomotor abnormalities and/or nystagmus consistent with central involvement were present in 10 of the 24 study participants tested. The precise cause of these findings remains unknown.

PMID:
21358450
[PubMed - indexed for MEDLINE]
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